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MATCH DAY 2014: A Neurologist to Be: The Road from Tehran to Mount Sinai

As a young child, Leila Montaser-Kouhsari, MD, PhD, was brought to her grandfather's hospital bedside. He'd been hit by a car and lay still in a coma. Neurosurgeons spent hours with him to no avail. Her grandfather, not yet 50, died the next morning. It was then that the six-year-old made a silent vow. She would grow up to become a doctor and help people with sick brains.

Now, almost 30 years later, she has her medical degree and a post-doctoral degree in neuroscience. The 35-year old matched to the Icahn School of Medicine at Mount Sinai in New York City. She has a strong interest in cognitive neuroscience that dates back to medical school in Iran. Her mentor, Hossein Esteky, PhD, was interested in visual perception and a small band of students found a computer and made their way online in search of papers on the topic. There were no books on neuroscience at Tehran University of Medical Sciences. The students, led by Dr. Esteky, held an ancient prayer ceremony during which they pledged to devote themselves to the study of the mind and body. Each of them did.

Dr. Montaser-Kouhsari loved neuroanatomy. She began reaching out to international scientists in the US for guidance in her studies. Many answered back, providing commentary and advice on her manuscripts. She published seven articles and an equal number of conference abstracts before she graduated medical school. She studied the role of attention and awareness in visual perception. She came to the US in 2004 and began her post-doctoral training in neuroscience at New York University. Her goal was to learn brain imaging, which she did. Her research was published in a lead article in the Journal of Neuroscience.

After finishing her PhD, Dr. Montaser-Kouhsari headed west to the California Institute of Technology, where she is a postdoctoral scholar. She studies neural correlates of decision-making. This year she applied to neurology residency programs. It was time, she said.

“I always wanted to be an academic neurologist,” she said.

Dr. Montaser-Kouhsari will be given an opportunity during her residency at Mount Sinai to do research. On the clinical side, she welcomes the challenges of this new age in medicine. “My hope is that more people will have access to care and arrive at my door earlier so that we can help them.”

Stuart Sealfon, MD, chairs the department of neurology at the Mount Sinai Health System and is professor of neurobiology, pharmacology and systems therapeutics at the Icahn School of Medicine at Mount Sinai. It's been 30 years since he was a resident.

“I tell residents that the way they practice neurology today will be different 10 years from now.” And that is the kind of doctor they want to attract: someone with a penchant for an ever-changing detective story.

“These new matches are going to inherit a field with a lot more options for patients,” said Stephen Krieger, MD, who has been the head of Mount Sinai's neurology residency program for five years. These days, residents must pick a sub-specialty and Dr. Krieger helps students figure out exactly where their interests lie. “Being a well trained neurologist is crucial,” said Dr. Krieger, an assistant professor of neurology. “People present with a cluster of symptoms and not a disease. They need skills to figure out what is wrong.”

Dr. Krieger remembers when he was a resident at Mount Sinai and a young woman arrived to the exam table with symptoms that looked like multiple sclerosis (MS). He remembers doing a spinal tap. He remembers sitting down with her and telling her the results and guiding her through a short course on the disease and the new treatments she would be taking to reduce the risk of future episodes. She was 28. Ten years have passed and she is still his patient. (His sub-specialty is MS.) They have both come of age: he now understands so much more about the disease and she does too.

Who comprises the next generation of neurologists? The second in a series to feature the newest graduating class of medical school students who matched to neurology residency training programs this past March.

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